Thursday, September 9, 2010

Paging Dr. Huxtable

There's something prophetic about that Cosby Show/Muppets bit.

A statistic I read this week in Time which originated from the American Journal of Medicine and the American Journal of Obstetrics and Gynecology, first shocked, and then, angered me. It stated that 31.2% of all births in the United States are performed by cesarean deliveries.

From a personal standpoint, I have experienced two births. One, a hospital birth and the other, a home birth- both were "natural" births where I declined pain medication and gave birth vaginally. I, myself, was born by c-section and I don't think that had any affect on my birthing decisions. However, I am perplexed regarding my mother's answer when asked why I was born this way, "I don't know," she said.

"What do you mean you don't know?"

"I can't remember. The doctor thought it was necessary for some reason, he recommended it. Then when I had your brother, they didn't want to risk a vaginal birth, so he was also born c-section."

I remember reading Macbeth in high school. We also read it elementary school, but Mr. Klaus, my 11th grade teacher and super crush, went much more in-depth. We spoke of the witches forecasting Macbeth's demise, "none of woman born shall harm Macbeth," was the most poignant. Macbeth thinks he is invincible, as all people come from women.

Later, the reader finds that Macduff

was born by cesarean, and at the time, would not have been considered "born" of woman. For some reason, I took that kind of personally. Hm?

Initially posting the statistic on my Facebook page, I received a few comments that allowed me further introspection and understanding about why I was reacting so strongly to hearing, definitively, that 1 in 3 babies will be born to mothers who had to undergo major surgery unnecessarily.

Certainly, there are times when emergency procedures are a logical alternative to reducing infant and maternal mortality. Having, myself, believed that birth, labor, and delivery (not at all discounting anyone having been in the adoption process, this topic is strictly about a woman's experience in labor and delivery) are all monumentally important in terms of gained, natural, life experience, I have difficulty understanding why the U.S. treats pregnancy like an illness.

My mother and I had a conversation when it was decided we were going to birth our daughter at home. I was firm in my belief that as a healthy woman with a healthy baby, who was under medical care, and who was confident that giving birth was as natural as eating, sleeping, or any other innate, human/mammalian trait. Mom believes in medicine. Now don't get me wrong, I believe doctors have good intent and are 100% needed, but I do not believe that, under normal circumstances, it is necessary to involve medical doctors in the birth process.

"Well, you wouldn't have lived if you weren't born in a hospital," she declared.

"But you planned the date I would be born. If you had just had me when your body was ready, I wouldn't have been 3 weeks premature, and I wouldn't have needed that care."

On June 28, 2002, my cervix was dilated to 3 cm. My younger daughter wasn't ready to be born until the 16th of July. Today, the average woman will run to the hospital, after all, she can't wait to have that baby... 39.5 weeks is a long damn time to be carrying around a parasitic alien and like Sigourney, she wants it out.

She will be admitted and then the clock starts ticking. From the time she walks in the door, she has about 48 hours to decide what to do. She can go home. If she stays and her contractions are not regular, doctors will recommend a shot of Pitocin to artificially induce the labor. If the Pitocin works, she will give birth within 24 hrs. If not, she will be forced to have her flesh, fat, muscles, tendons, uterus sliced open. She will be given a spinal injection which will render her useless, in earlier years, she was made to lie unconscious- unable to see her new baby or nurse her baby, all of whom are born higher than a fucking kite. It's no wonder people do drugs, they were high the moment they were born (pain medicines, especially)... that's right, I'm making the stretch.

Somehow in our fucked-up, idiot minds, major surgery became easier to perform than giving birth.

A doctor has more faith in his ability to perform surgery than in my ability to birth a baby.

Not only does the doctor assume that something MUST go wrong, it is then assumed that I will birth the baby in a hospital where people go when they are sick, injured, and dying. My mother said, "The only cheerful part about hospitals is the maternity ward."

Precisely.

That's right, in the midst of the death and disease box are brand new, generally healthy babies who must immediately receive immunizations, preventing hospital-born infection.

Here is a chart I found that helps one visualize the gradual decline in obstetrics philosophy and practice.In 1970, only about 6% of all women in the U.S. had performed cesareans.

Remember those Facebook friends who started me really thinking? Well, what they said was that, for doctors, c-sections are a matter of convenience. One friend said her doctor, "mentioned it as a way to know that she would deliver the baby (vs a random dr who is on call that day) and also as a way to have a convenient delivery for work purposes or so family could be there."

I would have run from that doctor, and thank goodness for sensible, bright friends who, with volition, know how to read and investigate without blindly accepting that doctors are as infallible gods.

I was also thinking about the money aspect of medical births. How much does it cost to deliver by c-section versus vaginally? Statistics I've read, say that it's about 2 to 1. Surgeons perform surgery, that's what they do, it's what they believe in... so, of course they're going to plug it.

Another argument made by c-section advocates says that the overall health of women and babies has increased with the rise in cesarean births. In its report on maternal health in the U.S., Amnesty International, it compared the U.S. to other countries where c-sections are not as commonplace, stating:

Maternal mortality ratios have increased from 6.6 deaths per 100,000 live births in 1987 to 13.3 deaths per 100,000 live births in 2006. While some of the recorded increase is due to improved data collection, the fact remains that maternal mortality ratios have risen significantly.

The USA spends more than any other country on health care, and more on maternal health than any other type of hospital care. Despite this, women in the USA have a higher risk of dying of pregnancy-related complications than those in 40 other countries. For example, the likelihood of a woman dying in childbirth in the USA is five times greater than in Greece, four times greater than in Germany, and three times greater than in Spain.

All I'm saying in all of this is that women should educate themselves before trusting a doctor more than one's self. Even if healthy women don't all rush to have home births, they should at least realize they can be empowered through knowledge and don't have to allow the doctor to perform unnecessary procedures like c-sections, faulty fetal monitoring, and episiotomies.

This isn't rocket surgery, people.

On a side note: As an M.P.A., I notice a correlation between Nixon's 1969 announcement of HMOs and the rising occurrence of c-sections. I also believe that all of our astronomical health care costs, across the board, are due to managed care.

2 comments:

Having been in the hospital scene as a med student in the mid 1970's, I can say that many docs and nurses considered C-Sections to be easier on the mother and baby then waiting around for natural childbirth to happen. With a part time job as a neo natal blood gas technician, it was my job to collect and analyze the blood of premies, and there was nothing worse than doing the gases of one baby, getting home, falling asleep, and then being woken in half an hour to come all the way back to the hospital to do another baby, that just happened to be born then..much easier to do them all at once on a schedule. We now know the cost of this convenience fell on the mother and child, but back then, all hospital techs were over worked and underpaid, and it was a relief to have a more regular schedule..

US spends more on health care! You betcherass! We got shinier toys and then their is the malpractice insurance, and the lawyers, who gotta have a Gulfstream.

C-sections are practical. Do you have any idea how many award dinners OBGYNs missed in the old days? How many had to stay up late just because most babies seem to prefer to be born in early hours of the mornings. I think we should not stand still until we have achieved full robotic C-sections and can outsource the actual operation to a qualified tech in China.

I'll bet most of those women used their vaginas to make that baby. How old fashioned. Little zippers or maybe a new Zip-lock sealer. We could install them in girls when they have their first periods. Zip it open, put that testube made baby in, when properly 'cooked', zipper her open and take it out.

"Walmart shoppers, we are having a special on the Ziplock Baby system. See Twanda in the Baby Center next to infant clothes."